외상과 턱관절 장애 연관성에 관한 연구

Abstract

Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain, joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks(ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely, 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.